Montero-Odasso Manuel, Schapira Marcelo, Soriano Enrique R, Varela Miguel, Kaplan Roberto, Camera Luis A, Mayorga L Marcelo
Division of Geriatric Medicine, McGill University, Montréal, Canada.
J Gerontol A Biol Sci Med Sci. 2005 Oct;60(10):1304-9. doi: 10.1093/gerona/60.10.1304.
Although gait velocity (GV) measurement could predict poor outcomes, few studies regarding its usefulness as a single test in well functioning elderly persons have been pursued. The aim of this study was to asses whether GV could be sufficient to predict adverse events such as hospitalization for any cause, requirement for a caregiver, nursing home placement, falls, fractures, or death in healthy elderly persons.
Ours was a cohort study comprising 102 well functioning participants aged 75 and older. Demographic features, health status, and functional capacity were assessed at baseline and followed for adverse outcomes. Measurements included evaluation of cognition, activities of daily living, and mobility. The time required to walk the middle 8 meters of 10 meters was defined as GV. Three GV groups were distinguished: high GV (>1.1 m/s), median GV (1-0.7 m/s), and low GV (<0.7 m/s).
At baseline, the three groups were comparable in their health status with an average age of 79.6 +/- 4 years. At 24 months, the low GV group had a significantly higher incidence of adverse events than did the other groups. Low GV was a predictor of hospitalization (relative risk [RR] = 5.9, 95% confidence interval [CI], 1.9-8.5), requirement of a caregiver (RR = 9.5, 95% CI, 1.3-2.5), and new falls (RR = 5.4, 95% CI, 2.0-4.3). These associations remained significant after a multiple logistic regression analysis.
GV measurement in the ambulatory setting may allow the detection of healthy elderly people at risk for adverse events. These data may suggest that simple assessment of GV is enough to predict adverse events in well functioning older persons.
尽管步速(GV)测量能够预测不良结局,但针对其作为一项单独测试在功能良好的老年人中的效用,相关研究甚少。本研究的目的是评估步速是否足以预测健康老年人中因任何原因住院、需要照料者、入住养老院、跌倒、骨折或死亡等不良事件。
我们进行了一项队列研究,纳入了102名75岁及以上功能良好的参与者。在基线时评估人口统计学特征、健康状况和功能能力,并随访不良结局。测量包括认知、日常生活活动和活动能力的评估。行走10米中间8米所需的时间定义为步速。区分出三个步速组:高步速组(>1.1米/秒)、中步速组(1 - 0.7米/秒)和低步速组(<0.7米/秒)。
在基线时,三组的健康状况相当,平均年龄为79.6±4岁。在24个月时,低步速组的不良事件发生率显著高于其他组。低步速是住院(相对风险[RR]=5.9,95%置信区间[CI],1.9 - 8.5)、需要照料者(RR = 9.5,95% CI,1.3 - 2.5)和新发跌倒(RR = 5.4,95% CI,2.0 - 4.3)的预测因素。经过多元逻辑回归分析后,这些关联仍然显著。
在门诊环境中测量步速可能有助于发现有不良事件风险的健康老年人。这些数据可能表明,简单评估步速足以预测功能良好的老年人中的不良事件。